Percutaneous Pulmonary Valve Implantation with the VenusP-valve without Long Sheath: First Outcomes from a Single-Center Experience

Percutaneous pulmonary valve implantation (PPVI) is an established alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction. The self-expanding VenusP-valve (Venus Medtech, Shanghai, China) enables treatment of large and heterogeneous RVOT anatomies. Implantation without a long sheath may simplify the procedure, reduce vascular manipulation, shorten procedure duration, and lower procedural cost. This retrospective study included 20 consecutive patients who underwent PPVI with the VenusP-valve between February and July 2025. All had previous RVOT surgery for congenital heart disease and presented with severe pulmonary regurgitation. The median age was 15.1 years (range: 10–29.8), and 15 patients (75%) were male. Implantation was successful in all cases, with sheathless advancement achieved in 19 patients. The median total procedure time was 77.5 minutes (range: 50–95) and the median fluoroscopy time was 13.2 minutes (range: 7.7–25.1). Two major complications occurred: one ventricular fibrillation during valve advancement, successfully terminated with defibrillation, and one pulmonary hemorrhage managed with an Amplatzer vascular plug. No valve embolization, coronary compression, or vascular injury occurred. At discharge, echocardiography demonstrated trivial or no pulmonary regurgitation in all patients. During a median follow-up of four months (range: 1–7), no reinterventions, infective endocarditis, or clinically significant arrhythmias were detected. VenusP-valve implantation in the pulmonary position without a long sheath is feasible, safe, and associated with favorable short-term outcomes. This simplified technique may streamline the procedure, reduce vascular manipulation, shorten procedure duration, and lower procedural costs.